(1 of 9)
September 2, 2003
CDC UPDATES PROVIDERS ABOUT ISSUES RELATED TO THE POWER OUTAGE AND VACCINE
STORAGE

On August 27, the National Immunization Program, Centers for Disease Control
and Prevention (CDC) updated its information for providers regarding
issues related to the recent power outage and vaccine storage. To access the
update, go to:
http://www.cdc.gov/nip/news/poweroutage.htm
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On August 25, the Centers for Disease Control and Prevention (CDC) issued a
press release announcing the supply of influenza vaccine for the 2003-04
influenza season is expected to meet the demand. The press release is
reprinted below.

Sufficient supplies of flu vaccine should be available during the coming
influenza season. The Centers for Disease Control and Prevention (CDC)
predicts that everyone wanting to get a flu shot to avoid influenza,
regardless of age or health status, should be able to get vaccinated as soon
as vaccine becomes available in October.

CDC estimates that vaccine manufacturers will produce approximately 85.5
million doses of influenza vaccine during the 2003 influenza season. This
projection represents 9.5 million fewer doses than were produced last year.
However, influenza vaccine production is expected to exceed the estimated 79
million doses that were actually sold to providers in 2002.

"Influenza vaccination is the best way to prevent influenza and its severe
complications," said Dr. Walter Orenstein, director of the CDC National
Immunization Program. "The best time to be vaccinated against influenza
continues to be October and November. However, vaccination in December or
later can still be beneficial."

Although anyone who wishes to avoid influenza should be vaccinated, CDC
strongly recommends influenza vaccination as soon as vaccine is available
for any person who is 6 months old or older and is at increased risk for
complications from influenza. Those at highest risk for complications from
influenza include people 65 years old and older, those with chronic,
long-term health problems such as heart or lung disease, kidney problems,
diabetes, asthma, anemia, HIV/AIDS, or any other illness that suppresses the
immune system. CDC also recommends vaccination for people age 50 to 64 years
because this group has an increased prevalence among those with high-risk
conditions. In addition, health care workers and others in close contact
with those at high risk should be vaccinated in order to reduce the
possibility of transmitting influenza to those at high risk.

Because young children also are at increased risk of influenza-related
complications, vaccination of children 6 to 23 months old, their household
contacts, and out-of-home caregivers is encouraged . . .

Production and distribution of the influenza vaccine was delayed in the
years 2000 and 2001. These delays prompted CDC to recommend that people 65
years of age and older and people with health conditions that put them at
high risk for complications from influenza be the first to receive the
vaccine. This recommendation helped to ensure that an adequate vaccine
supply was available to those at the greatest risk. Individuals without risk
factors were asked to wait until November to receive their vaccinations.

Influenza causes approximately 36,000 deaths and 114,000 hospitalizations
each year. More than 90 percent of deaths occur among people age 65 and
older.

Winter is the prime time for influenza. Influenza season typically ranges
from November through March or beyond. Flu activity peaked in January or
later during 22 of the past 26 influenza seasons. Heaviest influenza
activity occurred in December in four years, January in six years, February
in 11 years, March in three years, April in one year, and May in one year.

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September 2, 2003
DEATH OF DR. NATALIE SMITH IS A GREAT LOSS TO THE U.S. IMMUNIZATION
COMMUNITY

Natalie J. Smith, MD, MPH, died of cancer on August 22. She was 41.

Most recently, Dr. Smith served as the Deputy Director of the National
Immunization Program, Centers for Disease Control and Prevention. She
accepted the position at the National Immunization Program after serving
eight years as the Chief of the Immunization Branch, California Department
of Health Services.

In announcing Dr. Smith's death, Walter A. Orenstein, MD, Director, National
Immunization Program, wrote: "Let us take from Natalie the essence of her
life . . . . she knew who she was and what she believed in and brought it
into her daily life. Children and adults, both now and in the future, will
owe their protection from vaccine-preventable diseases, in large part, to
Natalie's outstanding contributions to the field of immunization."

A graduate of Stanford University, UCLA School of Medicine, and UC Berkeley,
Dr. Smith wrote numerous significant publications on immunization and
frequently presented/consulted on immunization-related issues to groups
representing public and private health sectors. She also sat on various
committees at the national level, including the Advisory Committee on
Immunization Practices.

All at the Immunization Action Coalition join in mourning the loss of Dr.
Smith.

(4 of 9)
September 2, 2003
AUGUST "IMMUNIZATION WORKS!" ELECTRONIC NEWSLETTER NOW AVAILABLE ON IAC
WEBSITE

"Immunization Works!" a monthly email newsletter published by the Centers
for Disease Control and Prevention, offers members of the immunization
community information about current topics. Some of the information in the
August issue has already appeared in previous issues of "IAC EXPRESS."
Following is the text of three articles we have not covered.

**********************

ANALYSIS OF STATE IMMUNIZATION LAWS: The Center for Health Services Research
and Policy [CHSRP] at George Washington University recently completed the
most comprehensive analysis undertaken to date of state laws regulating
immunization coverage. The study found that privately insured Americans face
potential and severe underinsurance where critical immunization protections
are concerned. Despite the fact that 32 states and the District of Columbia
include immunization coverage as a mandatory benefit under their health
insurance laws, CHSRP researchers found that state immunization mandates are
so limited that in most cases they offer children and adults little or no
insurance protection against the cost of essential immunizations. Tens of
millions of privately insured children and adults in the state-regulated
market are at risk for non-coverage of immunizations, not only in the case
of established vaccines, but even more significantly, for newly emerging
vaccines that may be recommended for public health protection by the CDC.
The report can be found at
www.gwhealthpolicy.org/news.htm

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ADULT IMMUNIZATION ASSESSMENT TOOL: CDC provides a computer-based program
which allows health care providers to assess the adult immunization rates
within their clinics. The program, ACASA, can be downloaded from www.cdc.gov/nip/casa A
separate program for childhood immunizations is also provided.

**********************

VOLUNTEERS NEEDED: CDC is seeking people who would like to be pilot testers
for immunization training programs. These are mostly self-study programs
that can be done through a CD-ROM or over the Internet. We are seeking
physicians, nurses, and health educators. The typical pilot testing effort
is to review a training program, take the evaluation, and provide feedback.
The process can take from 2 to 4 hours. Upcoming pilot testing activities
include "Smallpox Vaccine: Storage and Handling" and "Increasing Adult
Vaccination: What Works." Pilot testers can obtain continuing education
credits once the training program becomes approved for CE credit. If
interested, please contact Susan Farrall at sfarrall@cdc.gov or (404)
639-8852.

The website of the National Network for Immunization Information (NNii)
maintains information on state vaccine mandates. Parents and providers who
need information about which vaccines are required for school entry in their
state can easily access the information by going to the NNii website at
http://www.immunizationinfo.org/vaccineInfo/index.cfm#state

Scroll down to Search for State Vaccine Requirements for School Entry and
click on your state. You will be taken to a page that lists all the
childhood vaccines and gives detailed information about entry requirements
for your state.

The Immunization Action Coalition (IAC) also maintains a web section on
state vaccine mandates organized by disease on its website. The section also
has information about states that authorize pharmacists to vaccinate and
states that mandate influenza and/or pneumococcal vaccines for residents of
long-term health care facilities. In addition, IAC has recently added U.S.
maps that depict this information visually.

To access the information from the IAC website, go to:http://www.immunize.org/laws
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(6 of 9)
September 2, 2003
SEPTEMBER 5 IS THE REGISTRATION DEADLINE FOR CHOP'S VACCINE
EDUCATION SYMPOSIUM

The Vaccine Education Center at the Children's Hospital of
Philadelphia (CHOP) announced it will be hosting its third
annual Vaccine Education Symposium on September 13 in
Philadelphia. The registration deadline is September 5.

The one-day course will focus on new vaccines, how vaccines are
made and tested for safety, and how health care professionals
can address some of the concerns parents have about vaccines.
William L. Atkinson, MD, MPH, National Immunization Program,
Centers for Disease Control and Prevention, will give the
keynote lecture, "What's new in vaccines?" A panel will discuss
the topic "Talking to the 'immunization-hesitant' parent."

The Centers for Disease Control and Prevention (CDC) published
"Update: Adverse Events Following Civilian Smallpox
Vaccination--United States, 2003" in the August 29 issue of the
"Morbidity and Mortality Weekly Report" (MMWR). A summary made
available to the press is reprinted below in its entirety.

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Few adverse events, historically associated with smallpox
vaccine, have been reported, but monitoring for adverse events
continues at CDC and state vaccination programs.

During January 24-August 8, 2003, smallpox vaccine was
administered to 38,257 civilian health-care and public health
workers. Ongoing monitoring for vaccine adverse events has shown
that few adverse events have been reported. And, no cases of
vaccine virus transmission from civilian vaccinees to their
contacts have been reported.

HOW TO OBTAIN A FREE ELECTRONIC SUBSCRIPTION TO THE MMWR:
To obtain a free electronic subscription to the "Morbidity and
Mortality Weekly Report" (MMWR), visit CDC's MMWR website at: http://www.cdc.gov/mmwr Select "Free Subscription" from the menu
at the left of the screen. Once you have submitted the required
information, weekly issues of the MMWR and all new ACIP
statements (published as MMWR's "Recommendations and Reports")
will arrive automatically by email.
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(9 of 9)
September 2, 2003
CDC REPORTS ON POLIO ERADICATION IN ANGOLA AND THE DEMOCRATIC
REPUBLIC OF CONGO

The Centers for Disease Control and Prevention (CDC) published
"Progress Toward Poliomyelitis Eradication--Angola and the
Democratic Republic of Congo, January 2002-June 2003" in the
August 29 issue of the "Morbidity and Mortality Weekly Report"
(MMWR). A summary made available to the press is reprinted below
in its entirety.

**************************

In order to sustain the gains made in polio eradication in
Angola and in the Democratic Republic of Congo (DRC), high-quality polio surveillance and immunization must be maintained.

The estimated global occurrence of poliomyelitis has decreased
more than 99% since 1988, when the World Health Assembly
resolved to eradicate polio worldwide. Although wild poliovirus
(WPV) has not been detected for over a year in Angola and the
DRC, these countries remain a concern because of factors which
favor poliovirus transmission; including low routine
immunization coverage, recent civil conflict, and dense urban
populations. The detection of wild poliovirus in 2002 in Angolan
refugees in western Zambia and of high numbers of polio-compatible cases in northeastern DRC where large groups of
internally displaced persons have congregated due to ethnic
conflict highlights the potential for circulation of poliovirus
in these poorly vaccinated, high-risk populations. This report
summarizes progress made toward polio eradication during January
2002–June 2003.